Ch 18 Urinary System & Venipuncture Flashcards
1
Q
the urinary system includes:
A
2 kidneys, 2 ureters, a urinary bladder, and a urethra
2
Q
functions of the kidneys include:
A
removing waste products from the blood, maintaining fluid and electrolyte balance, and secreting substances that affect BP and other body functions
3
Q
urine is expelled from the body via the:
A
excretory system (aka urinary system)
4
Q
kidneys are what shape?
A
bean-shaped
5
Q
the lateral border is ____ and the medial border is ____
A
convex, concave
6
Q
each kidney is divided into:
A
upper and lower poles
7
Q
the kidney is _____ long
_____ wide
_____ thick
A
4.5” long
2-3” wide
1.25” thick
8
Q
the left kidney is usually:
A
slightly longer and narrower than the right
9
Q
the kidneys are situated:
A
behind the peritoneum (retroperitoneal) and are in contact with the posterior abdominal wall
10
Q
in reference to the spine the kidneys lie:
A
one on each side and on the same coronal plane as L3
11
Q
the superior aspect of the kidney is:
A
more posterior than the inferior aspect
12
Q
each kidney lies in a ____ plane and is rotated ____
A
oblique plane, rotated about 30 degrees anteriorly toward to aorta
13
Q
the kidneys normally extend from:
A
the level of the superior aspect of T12 to the transverse processes of L3
14
Q
the right kidney is ______ than the left
A
slightly lower (because of the liver)
15
Q
the renal capsule is the:
A
outer covering of the kidney
16
Q
each kidney is embedded in a mass of:
A
fatty tissue called the adipose capsule
17
Q
each kidney has an outer ____ and an inner ____
A
renal cortex, renal medulla
18
Q
the renal medulla contains:
A
renal pyramids
19
Q
the renal cortex has extensions called:
A
renal columns
20
Q
each kidney contains about 1 million:
A
nephrons
21
Q
an individual nephron is composed of a:
A
renal corpuscle and a renal tubule
22
Q
the renal corpuscle consists of a:
A
double walled membranous cup called the glomerular capsule (Bowman’s capsule) and a cluster of blood capillaries called glomerulus
23
Q
the glomerulus is formed by:
A
a branch of the renal artery entering the capsule and dividing into capillaries that unite to form a single vessel leaving the capsule
24
Q
afferent arteriole:
A
entering
25
efferent arteriole:
exiting
26
the glomerulus serves as a:
filter for the blood
27
the distal convoluted tubule open into the:
collecting ducts
28
calyces:
cup-shaped stems arising at the sides of the papilla of each renal pyramid
29
there are usually fewer ____ than _____
fewer calyces than pyramids
30
the major calyces unite to form:
the expanded, funnel-shaped renal pelvis
31
the renal pelvis becomes:
continuous with the ureter
32
each ureter is _____ long
10-12 inches long
33
the ureters enter the:
posterolateral surface of the urinary bladder
34
the ureters convey the urine from:
the renal pelves to the bladder by slow, rhythmic peristaltic contractions
35
the urinary bladder is a:
musculomembranous sac that serves as a reservoir for urine
36
the bladder is situated:
immediately posterior and superior to the pubic symphysis
37
the bladder in males is:
anterior to the rectum
38
the bladder in females is:
anterior to the vaginal canal
39
the apex of the bladder is:
anterior
40
trigone:
is the triangular area between the three orifices of the bladder
41
the urethra does what?
conveys urine out of the body
42
the urethra extends ___ in females and ____ in males
1.5" in females and 7-8" in males
43
the prostate is a:
small glandular body surrounding the proximal part of the male urethra
44
the prostate is considered:
part of the male reproductive system
45
the prostate measures ____ transversely
____ anterposteriorly at its base
___ vertically
1.5" transversely
.75" anteroposteriorly at its base
1" vertically
46
in preparing to administer drugs the technologist should:
follow the 5 rights
47
the 5 rights are:
```
right patient
right drug
right amount
right time
right route
```
48
to ensure that they right drug is given:
check the label on the container 3 times and the name
49
you should always check the _____
expiration date
50
routes are:
oral - by mouth
sublingual - under the tongue
topical - on the skin
parental - IV
51
mild symptoms of adverse reactions to iodinated contrast are:
nausea, vomiting, cough, sneezing, flushing, dizziness, anxiety, metallic taste, a few hives or rash, slight swelling of the eyes/face
52
moderate symptoms of adverse reactions to iodinated contrast are:
pulse change, hypotension, hypertension, dyspnea, bronchospasm, laryngospasm, hives, facial edema
53
severe symptoms of adverse reactions to iodinated contrast are:
unresponsiveness, convulsions, arrhythmia's, cardiopulmonary arrest, cyanosis, pulmonary edema, shock, renal failure
54
the most important thing to do before administration of water-soluble iodine contrast media is:
patient history
55
factors found in patient history that are factors in administering contrast media:
age, allergies, asthma, diabetes, coronary heart disease, hypertension, renal disease, multiple myeloma, sickle cell anemia, history of blood clots or COPD, previous iodine contrast use, pregnancy
56
scheduling protocol for patients:
why do they have priority for contrast media exams?
1. elderly
2. diabetic
3. children
4. adults
because they are NPO (no food)
57
priority order of multiple exams:
1. x-ray
2. nuc med (IVP)
3. urinary
4. barium/biliary
5. lower bowel (BE)
6. upper GI/small intestine
7. bronchography/lymphography
58
nonionic contrast media has osmolality which is:
a measure of the total number of particles in a solution per kilogram of water; how easily it dissolves in liquid
59
lower osmolality is more _____ and less likely to _____
more water soluble and less likely to be reactive with allergic effects
60
barium contrast is contraindicated when:
there is suspected perforation (don't use barium when checking for leakage in GI bands)
61
viscosity is _____; the friction of the media influences ____
the thickness of the media; the friction of the media influences the inject ability or delivery of the media
62
what is a way to do a faster injection?
heating the media to body temperature
63
________ plays a major part in the side effects; the ____ you inject the ______
the speed of injection; the faster you inject the more likely you will have side effects
64
tomography:
uses motion to show anatomic structures lying in a selected plane of pre-determined thickness, by blurring the images of structures above and below the plane of interest
65
the ___ and the ____ are moving while the ____ is still
the tube and IR are moving while the patient is still
66
as exposure angle increases, section ___ decreases
as exposure angle increases, section thickness decreases
67
in most IVP's you want "____" cuts
"thin" cuts (30-40°) requiring 3 or 4 different slices to visualize the whole kidney
68
the thinner the slice the _____
more detail for small parts
69
exposure arc is:
the angle (in degrees) which you will make your tube move
70
use (high/low) concentrations for bladder
low
71
use (high/low) concentrations for excretory urograms
high
72
adverse reactions to iodinated media are usually ____;
common reactions are:
mild and of short duration;
feeling warm, flushing, occasionally nausea, vomiting, and a few hives
73
preparation for intestinal wall includes:
bowel preparation is not attempted in:
NPO, intestinal tract free of gas and solid fecal material
not attempted in infants or children and depends on the condition of the adult patient
74
in preparation for retrograde urography have the patient:
drink 4-5 cups several hours before the examination
75
excretory urographic studies require a ____ marker
a time interval marker for each post injection study
76
urograms should show what anatomic structures?
outline of kidneys, lower border of liver, and lateral margin of the psoas muscle
77
immobilization band is usually not applied over the upper abdomen in a urogram because?
the pressure may interfere with the passage of fluid through the ureters and mat cause distortion of the canals
78
in excretory urography compression is sometimes applied over the distal end of the ureters why?
where on the body is the pressure applied?
to retard the flow of the opacified urine into the bladder and ensure adequate filling of the renal pelves and calyces
centered at the level of the ASIS
79
compression is contraindicated if the patient has:
urinary stones, an abdominal mass or aneurysm, a colostomy, a suprapubic catheter, traumatic injury, or recent abdominal surgery
80
all urogram use what respiration?
expiration because of he normal respiratory excursion, unless otherwise requested with appropriate marker
81
an abdomen x-ray is made before a specialized investigation of the urinary tract to:
reveal any extra renal lesions that are responsible for the symptoms and render the investigation unnecessary
82
a scout (recumbent) shows:
the contour of the kidneys, their location in the supine position, and the presence of renal calculi or calcifications; also to check preparation of the GI tract, check positioning, and to allow the tech to alter techniques
83
can males be shielded for a urogram?
yes, except for the examinations of the urethra
84
can females be shielded for a urogram?
only when the IR is centered over the kidneys - shield is placed over the pelvis
85
IVU shows:
the function and structure of the urinary system
86
urolithiasis is:
stones of kidney or urinary tract
87
pyelonephritis is:
infection of the upper urinary tract
88
hydronephrosis is:
abnormal dilation of the pelvicaliceal system
89
normal creatine level is:
0.6-1.2 mg/100mL
90
normal BUN level is:
8-25 mg/100mL
91
elevated creatine or BUN levels indicate:
renal dysfunction
92
the initial contrast "blush" of the kidney is termed the:
nephrogram phase
93
the greatest concentration of contrast medium in the kidneys normally occurs:
15-20 minutes after injection
94
most commonly recommended radiographs for IVU are __ projections at time intervals ranging from ______
AP projections ranging from 3-20 minutes
95
AP oblique projections may be taken at ___ degrees at ___ intervals
30° at 5-10 minute intervals
96
postvoid radiographs may be taken to detect?
presence of residual urine, small tumors, or enlargement of the prostate gland
97
for abdomen you want (long/short) contrast?
long (grays)
98
AP projection of the urinary system
```
SID:
patient position:
IR:
CR:
respiration:
```
SID: 40"
patient position: supine, support under the knees, center MSP, arms out of the way
IR: centered at the level of the iliac crests
CR: perp. to level of iliac crests
respiration: suspend on expiration
99
when contrast is introduced in the urinary system it becomes (long/short) scale
short (more B+W)
100
AP projection of urinary system should show:
kidneys, ureters & bladder filled w/contrast, entire renal outline, pubic symphysis, and a time marker
101
AP Oblique projection of the urinary system
```
SID:
patient position:
IR:
CR:
respiration:
```
SID: 40"
patient position: from supine turn patient so that MCP is at an angle of 30° from the IR, shoulders and hips in same plane, arms out of the way
IR: centered at the level of the iliac crests
CR: perp. entering at level of iliac crests and 2" lateral to the midline of the elevated side
respiration: suspend on expiration
102
AP Oblique projection of the urinary system should show:
30° rotation, both kidneys, no superimposition of the vertebrae, the bladder and lower ureters if they fit, and time marker
103
in the AP Oblique projection of the urinary system the kidney closest to the IR is _____, the kidney farthest from the IR is ______
closest is perp. to IR
| farthest is parallel with IR
104
Lateral projection of the urinary system
```
SID:
patient position:
IR:
CR:
respiration:
```
SID: 40"
patient position: lateral recumbent, R or L position, flex knees, MCP is centered to midline, flex elbows and place hands under head
IR: centered at level of iliac crests
CR: perp. entering MCP at level of iliac crests
respiration: suspend on expiration
105
Lateral projection of the urinary system shows:
is used to show what conditions?
kidney, ureters, and bladder filled with contrast
used to show rotation or pressure displacement of a kidneys and to localize calcareous areas and tumor masses
106
nephrotomography is used to show what?
the renal parenchyma (nephrons and collecting tubes) immediately after introduction of contrast media
107
nephrotomography is used to evaluate indications of:
renal hypertension, renal cysts, and renal tumors
108
nephrotomography is contraindicated by:
renal failure or contrast media allergies/sensitivity
109
retrograde urography requires:
the ureters to be catheterized so contrast can be injected directly into the pelvicaliceal system
110
in the oblique position the lower kidney is _____ to the IR
perpendicular
